Where evidence meets policy

Alcohol abuse isn’t just an issue for the young

Photo credit: Athanasius

Young people binge drinking has been a much talked about issue in recent times. Less talked about are the drinking habits of older people. A recent report by the Office of National Statistics (ONS) showed that in 2012 people aged 65 and over were the most frequent drinkers. For policy makers seeking to tackle the impact of alcohol on people’s lives and to reduce the cost to the NHS, this may require a shift in policy approach, says Lord Victor Adebowale, Chief Executive of the health and social care organisation Turning Point.

Britain has a complex relationship with alcohol. When you read the papers or watch television you will be bombarded with articles, news stories, soaps and advertisements all giving out different messages.

Most people will acknowledge that the UK has an issue with alcohol, however there is a growing realisation that for too long we have ignored the impact of alcohol on older adults, but rather focused our gaze on the more visible impact of young people going out on a Friday or Saturday.

It is vital that the local integration plans currently being developed include plans to tackle the impact of alcohol on the local population.

The fact is that the number of alcohol-related hospital admissions has more than doubled in the past decade to over 1.2 million in 2011/12. Of this total, the majority (almost 790,000) are people over the age of 55. This is putting a huge burden on the NHS. Public Health England (PHE) estimates that the cost of alcohol misuse to the NHS is £3.5billion annually in England alone.

The picture is made even more complex when we look at alcohol consumption over this period. At a time when harm caused by alcohol is increasing year on year, we might expect to see alcohol consumption increasing. In contrast statistics from both alcohol sales and self reported behavioural surveys, indicate that alcohol consumption has been falling over the past couple of years.

Alcohol over time

Our national relationship with alcohol has been changing over generations. The baby-boomers who are now hitting their 60s have had a different attitude to alcohol than previous generations. People in their 60s who have been drinking most of their lives without having any problems are now needing hospital care due to their drinking habits. It is estimated that over 1.4 million people over-65 drink above the recommended safe limits and in the past five years there has been a 62% rise in alcohol-related hospital admissions for over 65s.

In addition to the health implications of a lifetime of drinking, alcohol affects older people differently. As we age our bodies become more sensitive to alcohol. People who have been used to drinking regularly most of their lives might notice that alcohol begins to affect them more even though they may be drinking the same quantity. It is clear that we need to make sure we are educating everyone, not just the young, about the impact of alcohol.

The overall decrease in alcohol consumption, which I mentioned above, is welcome but it is important to look beyond the headline figures. The ONS report on trends in drinking highlights that the decrease in consumption between 2011 and 2012 was driven largely by the 25-44 age group. This suggests that older people may have maintained their previous drinking habits, which could be why we are still seeing increasing numbers of older people turning up to hospital.

There is also historical evidence that an economic downturn is followed by a reduction in alcohol use as people become more frugal. It has been widely reported that the downturn has disproportionately affected young people, supporting the evidence that it is younger people who are driving the reduction in alcohol consumption.

Intervention

This is too big an issue to be ignored, but what can be done to reduce the impact of alcohol on older people?

We certainly need to change the way we view early intervention – it’s not just for children and young people. There is substantial evidence that Brief Interventions can have lasting impact on people’s drinking behaviour regardless of their age. Evidence from Turning Point’s brief interventions in Sunderland Royal Hospitals shows that 57% of people who had brief interventions were not readmitted to hospital within six months. The Government’s announcement to include alcohol identification within the NHS Health Check for adults aged 40-75 is a welcome step towards preventing alcohol harm.

In June last year the Government announced the £3.8billion Better Care Fund which aims to improve integration of health and social care services. One of the key drivers of this policy is to reduce the number of hospital admissions amongst the elderly. Given the evidence outlined above, it is vital that the local integration plans currently being developed include plans to tackle the impact of alcohol on the local population.

We need to ensure that everyone gets access to alcohol treatment when they need it. PHE estimates that a quarter of a million people in the UK have a moderate or severe dependency to alcohol. If we improve access to treatment we will see benefits across society from employment to family life. Improving access may mean embracing new technologies to engage younger people or providing home visits to older people less able to leave their own homes.

We need to continue to fight the stigma associated with alcohol and drug dependency, which often prevents people from seeking help, including the elderly. Recovery is possible for everyone.